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Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
Published on: June 28, 2024
SNO-EANO-EURACAN consensus on management of pineal parenchymal tumors
Anthony P Y Liu1,2, Bryan K Li3,4, Alexandre Vasiljevic5,6
1Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
Abstract:
Pineal parenchymal tumors are rare neoplasms for which evidence-based treatment recommendations are lacking. These tumors vary in biology, clinical characteristics, and prognosis, requiring treatment that ranges from surgical resection alone to intensive multimodal antineoplastic therapy. Recently, international collaborative studies have shed light on the genomic landscape of these tumors, leading to refinement in molecular-based disease classification in the 5th edition of the World Health Organization (WHO) classification of tumors of the central nervous system. In this review, we summarize the literature on diagnostic and therapeutic approaches, and suggest pragmatic recommendations for the clinical management of patients presenting with intrinsic pineal region masses including parenchymal tumors (pineocytoma, pineal parenchymal tumor of intermediate differentiation, and pineoblastoma), pineal cyst, and papillary tumors of the pineal region.
Insights
Pineal parenchymal tumors are rare and diverse. This review offers updated diagnostic and treatment recommendations based on recent genomic research and the latest WHO classification for pineal region masses.
Area of Science:
- Neuro-oncology
- Genomic Medicine
- Tumor Classification
Background:
- Pineal parenchymal tumors are rare neoplasms with limited evidence-based treatment guidelines.
- Tumor biology, clinical presentation, and prognosis vary significantly, necessitating tailored treatment strategies.
- Recent genomic studies have advanced the understanding and classification of these rare tumors.
Purpose of the Study:
- To review current diagnostic and therapeutic approaches for pineal region masses.
- To provide pragmatic clinical management recommendations for healthcare providers.
- To integrate recent molecular and classification updates into clinical practice.
Main Methods:
- Comprehensive literature review of diagnostic and therapeutic strategies.
- Analysis of recent international collaborative studies on pineal tumor genomics.
- Synthesis of information based on the 5th edition of the World Health Organization (WHO) classification of CNS tumors.
Main Results:
- Pineal parenchymal tumors encompass a spectrum including pineocytoma, pineal parenchymal tumor of intermediate differentiation, and pineoblastoma.
- Molecular insights have refined disease classification, impacting treatment decisions.
- Management strategies range from surgical resection to multimodal antineoplastic therapy.
Conclusions:
- Updated classification and genomic data are crucial for managing pineal parenchymal tumors.
- Pragmatic recommendations are needed to guide the clinical management of intrinsic pineal region masses.
- Multidisciplinary approaches are essential for optimizing patient outcomes.
